Hyperhomocysteinemia in Chronic Kidney Disease Patients in a Teaching Hospital in Nigeria

Aim: To determine the prevalence of hyperhomocysteinemia amongst chronic kidney disease (CKD) patients at a Teaching Hospital in Nigeria and to determine its relationship with the severity of kidney disease.

Study Design: A comparative cross sectional study carried out in the department of Medicine in a Teaching Hospital in Nigeria between April 2012 and May 2013.

Methodology: A comparative cross sectional study among138 patients with CKD and 69 healthy consenting hospital staff individuals. Glomerular filtration rate was estimated for both patients and controls, using measured serum creatinine in the Cockcroft-Gault formula and the patients were grouped into the different stages of chronic kidney disease. All subjects had the homocysteine levels measurements using the enzyme- linked immunosorbent assay. Homocysteine levels were compared between healthy persons and CKD patients as well as within different stages of chronic kidney disease.

Results: Most of the CKD patients (47.8%) were stage 4, followed by (33.3%) stage 3 and stage 5 (14.5%). While stages 1 and 2 were the least (2.2% each). The mean age of the patients was 45.9 ± 16.5 years and 42.3 ± 14.7 years for control subjects. The prevalence of hyperhomocysteinemia was 57.9% amongst cases and 4.3% among control subjects with median homocysteine (Hcy) level being 19.1 µmol/l (IQR - 13.8) in cases and 8.3 µmol/l (IQR - 2.9) in controls, this was significant (P<.001), the chronic kidney disease patients having higher median homocysteine levels as the degree of kidney disease worsened.

Conclusion: The prevalence of hyperhomocysteinemia is high in CKD patients compared to controls and it increases as CKD progresses.